Once-a-month shot for opioid addiction works as well as daily medication, study finds

ByDavid Armstrong

October 18, 2017

Carla K. Johnson/AP

A once-a-month shot to treat opioid addiction was as effective in maintaining short-term abstinence from heroin and similar drugs as a more commonly prescribed daily treatment, according to a Norwegian study released Wednesday.

The study is believed to be the first to directly compare Vivitrol — administered as a monthly shot — with a combination drug treatment sold under the brand name Suboxone. In the U.S. and many other countries, Suboxone or methadone have been the standard medical treatment for people with an opioid use disorder.

Unlock this article by subscribing to STAT Plus and enjoy your first 30 days free!

I use methadone as I am 49 years old still do very physical work and have a bad back (from work injury’s) and I was ran over by a full size 4wd Chevy Trailblazer and it crushed my heel bone. They said I would have a bad limp and would have to work sitting down. At first I used pills and heroin off the street. Then METHADONE!!!! I got clean once on Suboxone but it little to nothing for my pain and I was about to lose my position at work and if I stayed with the company about half my salary was going to. So we’re all different but I’m my case methadone was a way way better form of treatment. Good luck and God bless allwho are seeking away back to good.

Actually vivatrol can and does increase the chance of a fatal overdose occuring.
The mind does not find satisfaction in vivatrol in the same way as it does on suboxone, because it is not an opiate. (This is advertised as a positive by the manufacturer of vivatrol)
How ever it is not. Addiction should be thought of in terms of years not months, and since the cravings for optiates are not satisfied by vivatrol and since it is very likely that sooner or later the addict being treated is going to stop with the medication, the result is a very high risk of relapse causing a fatal od in a person that is left with no defenses due to months on vivatrol

Vivitrol monthly shot is effective for only 3 weeks, but it works good for 3 weeks. Why is that an issue? Because insurance will only cover one shot every thirty days, leaving a week of high risk. The shot is about $1,300 each.
The active ingredient, Naltrexone, is also available in daily pill form for a fraction of the cost.

The other piece to note is that these were ppl who just finished detox, not folks seeking help in an outpatient setting who want help. Those in the outpatient setting and not willing to detox would not have qualified for this study and these results wouldn’t apply to that population. Otherwise, I’m really happy to see studies like this in process and finally being published.

Except for when an addict relapses while on Suboxone and does heroin or another opioid, they just get high. People who relapse while on Vivitrol die when they relapse, because their bodies aren’t able to tolerate their old dose of opioid. Suboxone has been studied for years. It’s the most effective treatment for opioid addiction. Vivitrol is being prescribed without a real understanding of the risks, by doctors or by patients or their families. This study funded by the Vivitrol manufacturer says it works. Surprise, surprise.

The previous comment that, “People who relapse while on Vivitrol die when they relapse, because their bodies aren’t able to tolerate their old dose of opioid” is patently false. I studied this exact question while at the company, and based on carefully controlled animal research, someone would have to use 10 to 20 times what s/he previously used just to feel the drug. The animals didn’t even show significantly diminished respiratory drive or motoric behavior at those doses. In the 7 years since Vivitrol’s approval, the FDA has NOT noted exceptional death rates. A larger study reported in the New England Journal of Medicine last year also did not find a notable death rate. Finally, the manufacturer did NOT find the head-to-head comparison study.
Let’s not bash any of these important medicines in the midst of a deadly epidemic that needs them!

While I’m a strong supporter of Medication Assisted Treatment and indeed work in Addiction Medicine where we are fighting the stigma of what’s proven to save lives, your statement regarding people dying while “on Vivitrol” is documentably false.

Perhaps if someone was abstinent for 6 months while on Vivitrol, discontinued the drug for well over a month and then relapsed, this might be a possibility. But this is the case after any prolonged period of abstinence for any reason, and certainly not attributable to the Vivitrol. When a patient is “on Vivitrol”, it’s not happening.

You just need a small bit of common sense,
The opposite of tolerance is sensitization,
Vivatrol causes sensitization, after it’s discontinued for a few weeks,
The chance of relapse during those weeks is very high,
Hense the chance of overdose after vivatrol is higher